Department of Orthopedic Surgery, Henry Ford Health System, Detroit, Michigan.
Wayne State University School of Medicine, Detroit, Michigan.
J Bone Joint Surg Am. 2022 Jul 6;104(13):1157-1165. doi: 10.2106/JBJS.21.01236. Epub 2022 Apr 22.
Multiple investigations in the past 50 years have documented a lack of racial/ethnic and gender diversity in the orthopaedic surgery workforce when compared with other specialties. Studies in other industries suggest that diversification of leadership can help diversify the underlying workforce. This study investigates changes in racial/ethnic and gender diversity of orthopaedic surgery leadership from 2007 to 2019 and compares leadership diversity to that of other surgical and nonsurgical specialties, specifically in terms of chairpersons and program directors.
Demographic data were collected from The Journal of the American Medical Association and the Association of American Medical Colleges. Aggregate data were utilized to determine the racial, ethnic, and gender composition of academic leadership for 8 surgical and nonsurgical specialties in 2007 and 2019. Comparative analysis was conducted to identify changes in diversity among chairpersons between the 2 years. Furthermore, current levels of diversity in orthopaedic leadership were compared with those of other specialties.
A comparative analysis of diversity among program directors revealed that orthopaedic surgery had significantly lower minority representation (20.5%) when compared with the nonsurgical specialties (adjusted p < 0.01 for all) and, with the exception of neurological surgery, had the lowest proportion of female program directors overall, at 9.0% (adjusted p < 0.001 for all). From 2007 to 2019, orthopaedic surgery experienced no change in minority representation among chairpersons (adjusted p = 0.73) but a significant increase in female representation among chairpersons, from 0.0% (0 of 102) to 4.1% (5 of 122) (adjusted p = 0.04). Lastly, a significant decrease in minority and female representation was observed when comparing the diversity of 2019 orthopaedic faculty to orthopaedic leadership in 2019/2020 (p < 0.05 for all).
Diversity in orthopaedic surgery leadership has improved on some key fronts, specifically in gender diversity among chairpersons. However, a significant decrease in minority and gender representation was observed between 2019 orthopaedic faculty and 2019/2020 orthopaedic leadership (p < 0.05), which was a trend shared by other specialties. These findings may suggest a more pervasive problem in diversity of medical leadership that is not only limited to orthopaedic surgery.
过去 50 年来，多项研究表明，与其他专业相比，矫形外科领域的种族/民族和性别多样性不足。其他行业的研究表明，领导层的多元化有助于使基础劳动力多样化。本研究调查了 2007 年至 2019 年期间矫形外科领导层的种族/民族和性别多样性的变化，并将领导多样性与其他外科和非外科专业进行了比较，特别是在主席和项目主任方面。
从《美国医学会杂志》和美国医学协会收集人口统计数据。汇总数据用于确定 2007 年和 2019 年 8 个外科和非外科专业学术领导层的种族、民族和性别构成。进行了比较分析，以确定这两年主席之间多样性的变化。此外，还比较了矫形外科领导层的多样性与其他专业的多样性。
对项目主任多样性的比较分析表明，与非外科专业相比，矫形外科的少数族裔代表人数明显较少（20.5%；所有比较的调整后 p < 0.01），并且总体上女性项目主任的比例最低，为 9.0%（所有比较的调整后 p < 0.001），除神经外科外。从 2007 年到 2019 年，矫形外科主席中的少数族裔代表人数没有变化（调整后 p = 0.73），但女性主席的代表人数显著增加，从 0.0%（102 人中的 0 人）增加到 4.1%（122 人中的 5 人）（调整后 p = 0.04）。最后，与 2019 年矫形外科教员相比，2019 年/2020 年矫形外科领导层的多样性观察到少数民族和女性代表人数显著减少（所有比较的 p < 0.05）。
矫形外科领导层的多样性在一些关键方面有所改善，特别是主席中的性别多样性。然而，在 2019 年矫形外科教员和 2019 年/2020 年矫形外科领导层之间观察到少数民族和性别代表人数的显著减少（所有比较的 p < 0.05），这是其他专业也存在的趋势。这些发现可能表明，医疗领导层的多样性存在更普遍的问题，不仅限于矫形外科。
